Mandrell, Ronald P

Mandrell, Ronald P is an individual health care provider with primary practice located at 1234 Empire St , Fairfield CA 94533-5711. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Mandrell, Ronald P can be contacted via phone (707) 426-3911.

Contact Information

Primary practice address
1234 Empire St Fairfield CA 94533-5711
Phone: (707) 426-3911
Fax: (707) 434-2029
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA06795 Texas

Profile Details

NPI number 1932285541
LBN Legal business name Mandrell, Ronald P
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 27th, 2006
Last updated May 23rd, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932285541 NPPES
California MEDICAID PA13843

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